New York's Medicaid fraud recoveries fell from $168 million in 2019 to $31 million in 2024, an 82 percent drop, under Attorney General Letitia James, and a Republican challenger with a federal prosecution background wants voters to know it.
Saritha Komatireddy, a former federal prosecutor and former chief of staff at the Drug Enforcement Administration, is making that collapse the centerpiece of her campaign for attorney general. The numbers come from the AG office's own annual reports, and Komatireddy isn't shy about what she thinks they mean.
As Fox News Digital reported, Komatireddy told the outlet in an interview:
"Even her Democratic predecessors used to bring in $200 to $300 million per year in fraudulent proceeds. When Tish James comes into office, it goes down to $20 to $30 million per year. According to her own year-end reports, she's just decided not to do that part of the job."
That framing, "she's just decided not to do that part of the job", is the sharpest line in an increasingly sharp race. And the data behind it deserves a careful look.
New York's Medicaid Fraud Control Unit was once a national leader in clawing back stolen taxpayer dollars. The historical record, drawn from annual reports, tells a consistent story across three Democratic attorneys general who held the office before James.
Under Eliot Spitzer, the unit recovered $243.6 million in 2006. Andrew Cuomo's office brought in $113.8 million in 2007, $263.5 million in 2008, and more than $283 million in 2009, totaling more than $660 million during his first three years as attorney general alone.
Eric Schneiderman, Cuomo's successor, recovered more than $335 million in 2012. That figure was described as the second-highest annual total in the unit's history and the highest in seven years.
Then James took office. Her first year, 2019, brought in $168 million, respectable, though well below the peaks her predecessors had hit. By 2024, the number had cratered to $31 million. The intervening years' figures were not detailed in the reporting, but Komatireddy characterized the James-era average as "$20 to $30 million per year." That characterization does not match the $168 million figure from 2019, suggesting she may be describing the later years of James's tenure.
It isn't just the dollar amounts. Komatireddy pointed to a parallel decline in criminal accountability. She told Fox News Digital that prior attorneys general secured roughly 100 criminal convictions per year for Medicaid fraud. Under James, she said, that number dropped sharply, with one year producing just eight convictions.
The specific year was not identified. But the broader pattern Komatireddy described, fewer prosecutions, fewer convictions, less money recovered, aligns with the recovery figures from the AG's own reports.
Meanwhile, New York's spending on its fraud recovery program has moved in the opposite direction. The state spent approximately $45 million on the program in fiscal year 2020. By 2025, that figure had risen to $70 million. More money in, far less money back.
James has faced scrutiny on other fronts as well. Her office contradicted its own position in a recent legal matter involving a New York City councilman's protest arrest, raising questions about internal coordination and priorities.
An unnamed spokesperson for James's campaign responded to the accusations by pointing to a federal report. The spokesperson told Fox News Digital:
"New York's MFCU has recovered more than $627 million for taxpayers since 2019 and was singled out by the Department of Health and Human Services this year as one of the nation's top-performing units, reporting more than half of all civil recoveries done by individual states for $272 million alongside Georgia and Indiana."
That $627 million cumulative figure since 2019 is worth examining. If recoveries started at $168 million in 2019 and fell to $31 million by 2024, a significant portion of that total was front-loaded. The trajectory matters as much as the sum, and the trajectory points down.
The spokesperson also dismissed Komatireddy as a proxy for the Trump administration, saying she was "more interested in auditioning for a role in the Trump administration than doing right by New Yorkers." That line is a familiar deflection in New York Democratic politics: when the numbers are inconvenient, change the subject to Washington.
The broader political landscape around James has grown more complicated. She has been publicly feuding with progressive challengers within her own party, accusing a socialist-aligned rival of damaging the Democratic brand in New York.
Komatireddy's campaign is not operating in a vacuum. The Trump administration has made Medicaid fraud enforcement a priority, particularly after a massive fraud scandal in Minnesota involving billions of dollars in alleged fraud tied to public assistance programs. Vice President JD Vance is leading the federal effort to crack down on the problem.
CMS Administrator Dr. Mehmet Oz sent a letter earlier this year to Governor Kathy Hochul asking for more information about how New York screens Medicaid providers and fights fraud. Oz stated the review was intended to protect Medicaid beneficiaries and maintain public confidence in the program. New York was one of only three states, along with California and Minnesota, to receive the letter.
That federal attention puts James in an uncomfortable position. If Washington is asking hard questions about New York's Medicaid oversight, the state's top law enforcement officer ought to have strong answers. The recovery numbers from her own annual reports do not provide them.
The federal push has carried real teeth. As previously covered, Vance has put blue-state officials on notice that criminal consequences could follow for those who enabled fraud, a warning that raises the stakes well beyond the usual campaign rhetoric.
Komatireddy spent more than a decade at the U.S. Attorney's Office for the Eastern District of New York before serving as chief of staff at the DEA. She is framing the attorney general's race around a basic proposition: the office exists to prosecute crime and fraud, and the current occupant has neglected that mission.
She told Fox News Digital she would add 20 criminal prosecutors to the Medicaid Fraud Control Unit if elected. She also connected the fraud enforcement failure to the broader fiscal pressure New York taxpayers face:
"It's New Yorkers who pay the price, because when people steal from Medicaid, that increases our healthcare costs. When we are just letting a billion dollars go out the door over the course of her term, that's money that we could be getting back as taxpayers."
Her reference to "a billion dollars" over the course of James's tenure is a characterization, not a precise accounting. But the gap between what prior attorneys general recovered and what James's office has produced in recent years is not a rounding error. It is a chasm.
Komatireddy also took aim at Albany's broader fiscal approach, tying fraud enforcement to the state's appetite for tax increases:
"The folks in Albany keep thinking of new ways to take more money away from taxpayers. If you had an attorney general who actually prosecuted fraud properly, you wouldn't have to worry about a tax hike."
That argument will resonate with New Yorkers who have watched their tax burden climb while the state's law enforcement apparatus appears to have pulled back from one of its most straightforward revenue-recovery functions.
The political environment around James continues to shift. Democratic primary challenges from the left have rattled the party establishment in New York, and James now faces pressure from both flanks, progressives who think she isn't radical enough and a Republican challenger who says she isn't doing the basic work of the office.
The HHS Office of Inspector General's 2025 annual report on Medicaid Fraud Control Units did name New York as one of four states, alongside Georgia, Colorado, and Indiana, responsible for recovering $272 million out of $506 million total recovered by individual states. James's campaign cited that finding as proof of strong performance.
But context matters. New York runs the largest Medicaid program in the country. Being one of four states that account for a large share of national recoveries is not the same as performing at the level the state's own history shows is possible. When Schneiderman's office alone recovered $335 million in a single year, a $272 million figure split among four states looks less like a triumph and more like a floor.
Komatireddy made the point plainly: "They're totally failing to prosecute Medicaid fraud, and you can look at that based solely on the record of Letitia James and her Democratic predecessors. This is not a partisan issue."
She is right that the comparison cuts across party lines, every predecessor she cited was a Democrat. The question is not whether a Republican or Democrat should hold the office. The question is whether the person holding it will do the work.
New York taxpayers spend $70 million a year on a fraud recovery program that now brings back less than half that amount. Somewhere, the math stopped adding up, and nobody in the current AG's office seems interested in explaining why.
